Research reveals alarming rates of suicidal ideation among older transgender adults

Transgender adults aged 50 or older in the United States face a significantly elevated risk of contemplating suicide due to the compounding impact of various challenges in different areas of their lives, according to a population-wide study.

More than one-fourth (25.8%) of this large pool of older transgender people acknowledged having thought about ending their lives at least once the previous year. That is a much greater prevalence than the 4.7% figure currently estimated for the adult population-at-large and substantially greater than the current estimated prevalence of 11–17% older adults in the U.S.

The new findings were published in the journal Aging & Mental Health, on the Transgender Day of Remembrance—an annual observance honoring the memory of transgender people whose lives were lost due to acts of anti-transgender violence.

The paper's conclusions highlight the urgent need for targeted support and interventions to reduce the prevalence of suicidal ideation within this vulnerable population.

"Our research has exposed the distressing reality faced by many older transgender adults who are grappling with suicidal thoughts due to the cumulative impact of multiple adverse factors on their lives," says co-author, Dr. Thomas Alex Washington, professor and BASW Program Director in the School of Social Work, College of Health and Human Services, at California State University, Long Beach.

"This underscores the critical need for comprehensive support, advocacy, and mental health resources to address this growing concern."

This study, which used data from the 2015 US National Transgender Survey, focused on a sample of 3,724 transgender adults aged 50 or older. More than one-quarter of respondents (25.8%) reported they had seriously contemplated ending their lives within the past year.

Notably, this number decreased with age, ranging from 31.7% among those aged 50-54 to 12.0% among those aged 70 or older.

The researchers examined five different areas of potentially-syndemic effects—workplace issues, interactions with professionals, use of public services, personal safety, and socioeconomic disadvantages. They wanted to determine the relationship between experiencing challenges in these areas and the likelihood of suicidal ideation.

The analysis revealed that all five areas examined significantly increased the odds of older transgender individuals contemplating suicide. The risk was heightened:

• by 96% to 121% among those experiencing challenges in any of the areas studied.

• by 258% to 1,552%, depending on the specific area, when individuals faced all of the challenges within a particular domain.

When all syndemic areas were combined, exposure to any of the challenges within an area raised the risk of contemplating suicide by 276%. Exposure to all the challenges examined increased the risk by 861%.

"This study demonstrates that most older transgender individuals encounter persistent challenges in various domains of their lives, significantly increasing their risk of contemplating suicide. These challenges interact in a syndemic manner, amplifying the risk of suicidal ideation," adds fellow co-author Dr. Hugh Klein, who is the founder and president of Kensington Research Institute, as well as a Research Faculty Associate in the School of Social Work at California State University—Long Beach.

"But encouragingly, we find that, among the older adults who participated in this large national study, the risk of contemplating suicide tends to diminish with advancing age, possibly due to greater resilience, adaptive strategies, changing life circumstances, and personal growth—all of which positive influence the mental health of transgender individuals as they get older."

However, the study is not without limitations. It relied on data over eight years old, potentially not fully reflecting the current situation for older transgender individuals in the rapidly evolving sociopolitical climate in the United States. Additionally, the study's limited scope of syndemic effects examined may not encompass the full spectrum of experiences and factors affecting older transgender adults.

The authors suggest that future research should explore a broader range of factors, compare different age groups and demographic subpopulations, and delve into nuanced aspects of mental health among older transgender individuals to better understand and address their unique needs and risks.